MEDICARE: DR. HOWARD LEOPOLD PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	008968-1	NY

General Provider Information

NPI Number	:	1821076746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD LEOPOLD PH.D.

Provider Business Mailing Address
First Line	:	10 PLAZA ST E
Second Line	:	9C
City	:	BROOKLYN
State	:	NY
Zip	:	11238-4954
Country	:	US
Telephone Number	:	718-857-4650
Fax Number	:	718-857-4650

Provider Business Practice Location Address
First Line	:	1 PLAZA ST W
Second Line	:	1D
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3748
Country	:	US
Telephone Number	:	718-857-4650
Fax Number	:	718-857-4650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	07/08/2007

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